| NPI | 1831327865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO 55166) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2009016703) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2014-00466) | |
| 207X00000X Orthopaedic Surgery (Licence: CO 55166) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-01-14 |